The number of women aware that heart disease is the leading cause of death has nearly doubled in the last 15 years, but that knowledge still lags in minorities and younger women, according to a new study in the American Heart Association journal Circulation.

Researchers comparing women’s views about heart disease in 1997 and today, found:

  In 2012, 56 percent of women identified heart disease as the leading cause of death compared with 30 percent in 1997.
  In 1997, women were more likely to cite cancer than heart disease as the leading killer (35 percent versus 30 percent); but in 2012, only 24 percent cited cancer.
  In 2012, 36 percent of black women and 34 percent of Hispanic women identified heart disease as the top killer - awareness levels that white women had in 1997 (33 percent).
  Women 25-34 years old had the lowest awareness rate of any age group at 44 percent.

The study showed barriers and motivators to engage in a heart healthy lifestyle are different for younger women, who also said their doctors were less likely to talk to them about heart disease.

“This is a missed opportunity,” said Lori Mosca, M.D, M.P.H., Ph.D., lead author of the study. “Habits established in younger women can have lifelong rewards. We need to speak to the new generation, and help them understand that living heart healthy is going to help them feel better, not just help them live longer. So often the message is focused on how many women are dying from heart disease, but we need to be talking about how women are going to live — and live healthier.”

In August-October 2012, researchers conducted online and telephone surveys with more than 1,200 women, 25 and older. They compared results from surveys taken in 1997, 2000, 2003, 2006 and 2009. The survey assessed women’s lifestyle, awareness of the leading cause of death and warning signs of a heart attack, and what they would do if they experienced heart attack symptoms.

Among the women surveyed:

  61 percent said the reason they would take preventive action was to feel better, compared to 45 percent who would be motivated to take preventive action in order to live longer.
  Racial and ethnic minorities reported higher levels of trust in their healthcare providers compared with whites, and were also more likely to act on the information provided dispelling the myth that mistrust of providers contributes to disparities.
  Self-reported depression was common (26 percent) among respondents and has been previously reported as a barrier to adherence to medical guidelines.
  Compared with older women, younger women were more likely to report not discussing heart disease risk with their doctors (6 percent among those 25-34 versus 33 percent for those 65 and older).

Mosca said efforts need to be age-appropriate and culturally sensitive to reach younger women and more minorities who are at high risk for heart disease.

“There are gaps between women’s personal awareness and what they’re doing in terms of preventive steps,” said Mosca, director of preventive cardiology at New York-Presbyterian Hospital and professor of Medicine at Columbia University Medical Center. “The American Heart Association has well-established, evidence-based guidelines about heart disease prevention, so we have to better align women’s actions with what is evidence-based.”

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Co-authors are Michelle A. Albert, M.D., M.P.H.; Gmerice Hammond, M.D,; Jean Harvey-Berino, Ph.D.; Jean McSweeney, Ph.D., R.N.; Heidi Mochari-Greenberger, Ph;D.; M.P.H., R.D.; Jane Reckelhoff, Ph.D.; Mathew J. Reeves, Ph.D.; Amy Towfighi, M.D.; and Judy L. Bezanson, D.S.N., R.N. Author disclosures are on the manuscript.

The National Institutes of Health funded the study.

The American Heart Association’s Go Red For Women movement encourages women of all ages to know and reduce their risk for heart disease and provides tools to lead a heart healthy life. The campaign, now entering its 10th year, offers a variety of ways to become actively involved in helping all women make healthier choices.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content.

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Cathy Lewis
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American Heart Association